[unreadable] The care of chronic hepatitis C (HCV) infection among drug users, many of whom are co-infected with HIV, is an important public health problem. For drug users with chronic HCV infection, alcohol and active drug abuse, high rates of depression, susceptibility to hepatitis A and B infections, and HIV co-infection are only a few of the variables that affect engagement in and outcome of HCV chemotherapy. Attention to these "pre-chemotherapeutic" factors prepares drug users for future and possibly more efficacious HCV chemotherapy. However, little is known about whether these "pre-chemotherapeutic" factors are successfully addressed in the context of chronic HCV management. [unreadable] [unreadable] The candidate proposes the following specific aims: [unreadable] 1) To determine rates of engagement in pre-chemotherapeutic care among drug users with chronic HCV infection. [unreadable] 2) To determine factors associated with awareness and acceptance of interventions other than specific chemotherapy for reducing the progression of chronic HCV infection and preparing for future chemotherapy. [unreadable] [unreadable] The candidate proposes a five-year prospective study of engagement in and factors associated with pre-chemotherapeutic care for hepatitis C infection, among HCV-infected drug users participating in two ongoing cohort studies of men and women with or at risk for HIV. Participants will be screened and enrolled at a semi-annual research visit for the parent studies. At each semi-annual research visit, study participants will undergo standardized interviews to gather data on demographics, sexual and drug-using behaviors and medical history, including symptoms of and treatment for hepatitis. In addition, blood will be drawn for laboratory assays including HCV antibody and HCV RNA levels. [unreadable] [unreadable] The purpose of this K23 grant proposal is to support this candidate as she develops her clinical research career and undertakes studies in HCV-infected drug users with or at risk for HIV, under the mentorship of experienced investigators. [unreadable] [unreadable] [unreadable] [unreadable]